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Consulting
OASIS and Clinical Workflows
Implementing our workflows will decrease your labor and mileage costs and easily save you $300-$500.00 per 60-day episode of care. This straightforward implementation allows you to care for more patients with the same number of staff.
TPE Audits
Targeted Probe and Educate audits are always data-driven. If you do not understand how CMS intermediaries are targeting the claims they audit and know precisely what they are looking for, you will be frustrated and lose quite a bit of money in the process. Most audits can be remediated in 7-10 days, and release from a TPE audit within 30 - 60 days is realistic.
UPIC Surveys & Extrapolation
If you are in a UPIC survey/audit it is usual and customary to have been referred to the DOJ for a fraud waste and abuse review of the data you submitted to your intermediary with your claims.
In order to respond to the extrapolation properly it is essential to know and understand what data elements in the OASIS and Billing audit teams used to claim the multi-million dollar overpayment.
The Team
Our Coding Team
Our team has worked in Acute care settings and for HMO-Managed Care Medicare payers.
Each has at least five years of experience as an RN, is certified by the BAMC, and has had extensive training in OASIS-E and PDGM reimbursement.
Michael McGowan
A former OASIS coordinator for CMS region IX, Mr. McGowan has had an extensive regulatory and compliance background in the home health industry since 1998.
He has designed and deployed PDGM and OASIS analytics software nationwide and continues to work with agencies' ICD-10 coding, OASIS Reviews, Fiscal Intermediary, and UPIC audits.